• 제목/요약/키워드: Enhanced Pain

검색결과 207건 처리시간 0.025초

2021년 경남지역 Salmonella enterica serotype Enteritidis 원인 식중독의 분자역학적 특성 분석 (Molecular Epidemiological Analysis of Food Poisoning Caused by Salmonella enterica Serotype Enteritidis in Gyeongnam Province of Korea)

  • 장혜정;하연경;유선녕;김소영;엄지연;하강자;김동섭;이상률;안순철
    • 생명과학회지
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    • 제33권1호
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    • pp.56-63
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    • 2023
  • 2021년 국내에서 가장 많은 수의 식중독 환자가 Salmonella로 인해 발생하였고, 전 세계적으로도 꾸준한 발생이 보고되고 있다. 본 연구에서는 2021년 9월 중 경상남도에서 발생한 2건의 Salmonella 원인의 식중독에 대한 사례 보고 및 분리된 Salmonella 균주의 분자역학적 특성을 분석하였다. 학교 급식 사례는 동일 섭취원 588명 중 29명(4.9%)이 설사 및 복통 증상을 보였고 36명(환자 29, 조리 종사자 7)에 대한 검사 결과, Salmonella Enteritidis가 환자 17명(47.2%)에서 검출되어 주원인으로 판단되었다. 식품 및 환경 검체 35건에서는 S. Enteritidis가 검출되지 않았다. 다음으로, 회사 내 발생 사례는 동일 섭취원 2,900명 중 87명 (3.0%)이 설사, 복통, 발열 증상을 보여 50명(환자 40, 조리 종사자 10)을 검사를 했고, 그 결과 환자 28명 (56.0%)에서 S. Enteritidis가 검출되었다. 그중 4명은 Vibrio cholerae (NAG)와 S. Enteritidis가 중복 검출되었고 1명은 V. cholerae (NAG)만 검출되었다. 이는 S. Enteritidis와 복합적으로 작용했을 가능성을 배제할 수는 없지만 주원인으로는 S. Enteritidis로 판단되었다. 식품 및 환경 검체 125건 중 보존식에서는 S. Enteritidis가 불검출이었으나, 회사에서 단체로 배달 주문하여 섭취한 토스트에서 S. Enteritidis가 검출되었다. PFGE 유전학적 상동성을 분석한 결과, 환자와 식품에서 분리된 S. Enteritidis 균주가 동일한 유형으로 확인되었다. 이는 앞서 발생한 경남지역 학교 사례와 타 지역 사례의 환자 분리 균주와도 동일한 유형으로 확인되어 문제성이 더욱 제고되고 있다. 이와 같이 S. Enteritidis 원인 식중독의 분자역학적 특성 분석을 통해 역학적 관리 및 식중독 예방에 필요한 자료를 제공하고자 한다.

급성심근경색증에서의 심장자기공명영상술의 진단 정확도와 심근 생존력 평가: TI-201 심근관류 SPECT와의 비교 (Diagnostic Accuracy and Evaluation of Myocardial Viability by Cardiac Magnetic Resonance Imaging in Acute Myocardial Infarction: A Comparison with Thallium-201 Myocardial SPECT)

  • 김혜선;박동우;김용수;김영선;최요원;전석철;서흥석;함창곡;김순길;안유헌;최윤영;박충기
    • Investigative Magnetic Resonance Imaging
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    • 제7권2호
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    • pp.100-107
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    • 2003
  • 목적 : 급성심근경색을 진단하는데 있어 심장자기공명영상의 유용성을 알아보고, 생존심근을 평가하는데 있어 Tl-201 심근관류 SPECT와 비교하고자 하였다. 대상 및 방법 : 흉통 및 호흡곤란이 있는 환자 중 심장자기공명영상과 Tl-201 SPECT를 시행한 17명을 후향적으로 조사하였다. 심장자기공명영상에서는 T2강조영상에서 심벽의 고신호 강도 유무, 영화영상에서 심벽 운동, Gd-DTPA 조영 증강 후 좌심실 벽의 관류 결손 및 주입 15분 후의 지연조영증강 유무를 평가하였다. T1-201 SPECT에서는 아데노신 부하 영상과 휴식기 영상을 얻어 관류 결손 유무와 관류 결손시 가역성 여부를 평가하였다. 결과 심장자기공명영상과 T1-201 SPECT 모두 급성심근경색을 진단하는데 통계적으로 의미가 있었고, T2강조영상, T1-201 SPECT, 지연조영증강 및 심벽운동 순으로 연관성이 있는 것으로 나타났고, 관류 결손은 통계적 유의성이 없었다. 생존심근 평가에 있어서는 두 검사간 유의한 차이가 없었으며, T2강조영상과 관류영상에서 T1-201 SPECT와 높은 일치율, 지연조영증강 및 심벽운동은 낮은 일치율을 보였다. 결론 : 심장자기공명영상은 급성심근경색을 진단하는데 매우 유의한 진단율을 보였고, 생존 심근여부의 판단에 있어 SPECT와 높은 일치율을 보였다. 그러나 각 검사별 판독 기준과 방법에서 많은 연구가 필요할 것으로 생각된다.

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조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발 (Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery)

  • 황보수자
    • 간호행정학회지
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    • 제6권1호
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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일부지역 노인복지관 노인들의 주관적 구강건강상태에 따른 사회적 효능감 및 구강건강관련 삶의 질에 관한 연구 (A Study on Social Efficacy of Senior Citizens in Welfare Centers in Some Areas according to Their Subjective Oral Health and Their Quality of Life related to Oral Health)

  • 박홍련;구인영;문선정
    • 한국산학기술학회논문지
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    • 제15권2호
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    • pp.1000-1009
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    • 2014
  • 본 연구는 인구사회학적 특성에 따른 주관적인 구강건강상태와 주관적인 구강건강상태인식에 따른 사회적 효능감과 삶의 질, 구강건강 관련 삶의 질을 알아보고자, 2013년 1월 9일부터 2013년 6월 5일까지 대구광역시 7개의 구에 있는 6개의 노인복지관을 이용하는 노인 582명의 설문지를 분석하여 다음과 같은 결론을 얻었다. 성별은 치통과 구강건조증, 연령층별은 구강건강상태, 음식저작 장애, 치주문제, 구강건조증, 최종학력에서는 구강건강상태, 음식저작 장애, 치통, 치주문제, 동거가족 수에서는 음식저작 장애, 치통, 치주문제, 구강건조증, 구취에서 통계적으로 유의하였다. 구강건강상태에 따른 사회적 효능감 항목에서 '나의 구강은 건강하지 않다'가 3.11점이었고, '나는 턱에서 소리가 나거나 아프다'가 1.99점이었다. 구강건강상태 인식에 따른 사회적 효능감에서 건강은 2.05점, 삶의 질에서 건강은 3.41점이었다. 구강건강관련 삶의 질 점수에서 건강의 경우 기능적 제한은 2.13점, 신체적 동통은 2.53점, 심리적 불편은 2.17점, 신체적 제한은 2.31점, 심리적 능력저하는 2.06점, 사회적 능력저하는 1.81점, 사회적 불리는 1.99점이었다. 노인구강건강증진을 위한 지속적인 구강보건교육의 기회제공과 예방프로그램의 개발을 통하여 구강건강이 진행되지 않도록 적극적인 방안모색이 충분히 고려될 때 노인의 구강건강 뿐만 아니라 삶의 질까지 향상될 수 있을 것으로 사료된다.

인공관절 전치환 성형 수술 전후의 일상활동 장애정도 및 삶의 만족도 비교연구 - 관절 질환 환자를 중심으로 - (A Comparative Study of the Handicaps in and Satisfaction with the Ordinary Life before and after the Plastic Operation for Artificial Joint Replacement-Centering around Those Who suffer from Joint Diseases)

  • 강신화
    • 근관절건강학회지
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    • 제3권1호
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    • pp.37-49
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    • 1996
  • The joint diseases threaten modern people's healthy life. They bring about a long pain, an anasarca, loss of joint function or even deformation and rigidity of joint, limiting people's ordinary activities much. The chronic joint patients may be subject to some hypochondria caused by anxiety for their life, social isolation, financial problem and physical disability. Therefore, this population should continue to be duely taken care of by medical personnels. In particular, nurses should adequately help these people to recover and improve their health through suitable adaptations. With such basic conceptions in mind, this study was aimed at reviewing these patients' conditions in their ordinary life before and after a plastic operation for artificial joint replacement as well as their satisfaction with their life. For this purpose, those patients who underwent some plastic operations for artificial joint replacement at university hospitals in Seoul from January 2, 1993 to June 30, 1995 were selected as the population of this study. Among them, 87 people were randomly sampled to answer a questionnaire designed specially. For the surveying tools, Jette's (1980) scale was applied to address the sample people's inconveniences experienced and supports received in their ordinary life, while the scale of Wood, Wylie & Sheafer was used to measure their satisfaction with their life. The collected data were analyzed for percentiles, means, SD, t-test and Pearson's correlations. The results of survey can be summarized as follows ; As a result of t-test the frequencies of other people's support before and after the plastic operation, it was disclosed that those who underwent the operation were supported less frequently. In addition, as a result of t-testing their satisfaction with life before and after the operation, it was found that the operation increased their satisfaction with life significantly. Meanwhile, as a result of t-test inconveniences, frequencies of supports and life satisfaction before and after the plastic operation for artificial knee replacement, it was disclosed that only the inconveniences were significantly reduced after the operation. In contrast, the t-test the variables before and after the plastic operation for artificial hip replacement, it was found that only the frequencies of other people's supports were significant reduced after the operation. Furthermore, the differences 6 months, one year and two years after the plastic operation for artificial joint replacement were t-tested on the variables. As a result, it was disclosed that people's inconvenience, frequencies of supports and life satisfaction were not improved 6 months after the operation but their frequencies of supports decreased significantly one year after, while their inconveniences and life satisfaction were significantly improved two years after. As a result of analyzing the variables with Pearson's correlations, inconveniences and frequency of supports were negatively correlated significantly with the life satisfaction. In conclusion, the plastic operation for artificial joint replacement significantly improved people's living inconveniences, reduced their frequency of other people's support and enhanced their satisfaction with life. To break don the plastic operation for artificial knee replacement improved patients' inconveniences, while the plastic operation for artificial hip replacement not only improved patients' inconveniences but reduced the frequencies of other people's support also. Finally, the finding that the plastic operation for artificial joint replacement brought about the improvement two years after suggests that this period is needed for the patients to adapt themselves to the post-operation conditions.

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Enhanced immunity effect of Korean Red Ginseng capsule: A randomized, double-blind and placebo-controlled clinical trial

  • Yi Yang;Jing Li;Shengyuan Zhou;Daoyan Ni;Cailing Yang;Xu Zhang;Jian Tan;Jingrui Yan;Na Wang
    • Journal of Ginseng Research
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    • 제48권5호
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    • pp.504-510
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    • 2024
  • Background: As a physiological function of body, immunity can maintain health by identifying itself and excluding others. With economic development and increasingly fierce social competition, the number of sub-healthy population is gradually increasing, and the most basic problem exposed is human hypoimmunity. Hypoimmunity can be manifested as often feeling tired, catching colds, mental depression, etc. In order to enhance immunity, eating healthy foods with the effect of enhancing immunity may become an effective choice. KRG has pharmacological effects of enhancing immunity. Because the screening and evaluation method of immune population are not unified, there are relatively few KRG immunity tests for sub-health population. It is of great significance to study the effect of KRG on people with hypoimmunity to improve sub-health status. Methods: This was a 180-day, randomized, double-blind, placebo-controlled clinical trial. According to the trial scheme design, 119 qualified subjects were included and randomly divided into the test group taking KRG and the placebo control group. Subjects need to check safety indicators (blood pressure and heart rate, blood routine, liver and kidney function, urine routine and stool routine) and efficacy indicators (main and secondary) inspection at baseline, efficacy indicators inspection during the mid-term of the test (90th days of administration), safety and efficacy indicators inspection after the test (180th days of administration). Results: After the test, the safety indicators of placebo control group and KRG test group were basically within the normal range, and there is no significant difference in fireness score between the two groups. Through follow-up interviews, it was found that the subjects in the test group and the control group had no adverse reactions and allergic reactions such as nausea, flatulence, diarrhea, and abdominal pain during the test period. Self-comparison of the test group, the results of the main efficacy indicators: (1) immune related health scores were significantly improved in the mid-term and after the test (P < 0.01), (2) CD3 and CD4/CD8 increased significantly after the test (P < 0.05), (3) IgG, IgA, IgM and WBC increased significantly in the mid-term and after the test (P < 0.01); the results of the secondary efficacy indicators: (1) TNF-α decreased significantly in the midterm (P < 0.05), IFN-γ decreased significantly in the mid-term (P < 0.01), (2) NK increased significantly in the mid-term and after the test (P < 0.05), (3) monocyte increased significantly in the mid-term and after the test (P < 0.01). Inter-group comparison of the test group and the control group, the results of the main efficacy indicators: (1) immune related health scores were higher than that of the control group in the mid-term and after the test (P < 0.01), (2) IgA of the test group was higher than that of the control group in the mid-term and after the test (P < 0.05); the results of the secondary efficacy indicators: (1) WBC of the test group was higher than that of the control group in the mid-term (P < 0.05); (2) monocytes of the test group were higher than that of the control group in the mid-term and after the test (P < 0.05), neutrophils of the test group were higher than that of the control group in the mid-term (P < 0.05). Conclusion: Taking KRG has no adverse effects on the health of the subjects. According to the standard of clinical trial scheme, the immune related health scores and IgA in the main efficacy indicators were positive, which shows that KRG is helpful in enhancing human immunity.